Department of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, 00185 Rome, Italy.
Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Via Borelli 50, 00161 Rome, Italy.
Int J Mol Sci. 2021 May 25;22(11):5613. doi: 10.3390/ijms22115613.
Cholangiocarcinomas (CCAs) are heterogeneous biliary tract malignancies with dismal prognosis, mainly due to tumor aggressiveness, late diagnosis, and poor response to current therapeutic options. High-throughput technologies have been used as a fundamental tool in unveiling CCA molecular landscape, and several molecular classifications have been proposed, leading to various targeted therapy trials. In this review, we aim to analyze the critical issues concerning the status of precision medicine in CCA, discussing molecular signatures and clusters, related to both anatomical classification and different etiopathogenesis, and the latest therapeutic strategies. Furthermore, we propose an integrated approach comprising the CCA molecular mechanism, pathobiology, clinical and histological findings, and treatment perspectives for the ultimate purpose of improving the methods of patient allocations in clinical trials and the response to personalized therapies.
胆管癌（CCA）是一种异质性胆道恶性肿瘤，预后不良，主要归因于肿瘤侵袭性、晚期诊断以及对现有治疗方案的反应不佳。高通量技术已被用作揭示 CCA 分子特征的基本工具，并且已经提出了几种分子分类，从而导致了各种靶向治疗试验。在这篇综述中，我们旨在分析精准医疗在 CCA 中的关键问题，讨论与解剖分类和不同病因发病机制相关的分子特征和聚类，以及最新的治疗策略。此外，我们提出了一种综合方法，包括 CCA 的分子机制、病理生物学、临床和组织学发现以及治疗观点，以期最终改善临床试验中患者分配的方法和对个性化治疗的反应。
